This past February, I had a pacemaker optimization performed. Doc. stood behind the sonographer and watched the ultrasound images on the screen and gave instructions to a device nurse to change my PM settings to this, that or the other thing. Final result was a claim that my LVEF was raised from 20% to 35%+ altho I didn't feel that much better. Fatigue continued. Couple days ago, I had a right and left heart Cath ------------ no blockages, YAY!! In a couple more days, I'll have a 2D echo performed (will it show things that didn't show during the earlier PM optimization?) Finally, my pulmonologist wants a chest CT scan performed. All this to try to track down the cause of my lingering fatigue and unintended weight loss (180 lbs in Jan. - 163 today) that began early this year after a bout with pneumonia - along with my continuing low blood pressure (usually 88/52) - Docs have halved my daily metoprolol and tamsulosin dosages in the attempt to raise my BP - I'm thinking of lowering them to the figure of zero and see what happens! Anyone here have a similiar eperience with this scenario?